ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Individual-level Association of Influenza Infection With Subsequent Pneumonia: A Case-control and Prospective Cohort Study.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 15 citations in OpenAlex.
- State-of-the-art of the high dose influenza vaccine in Spain.Frontiers in immunology · 2026Review
- Mapping the Surveillance Data Infrastructure in the U.S. for SARS-CoV-2, Influenza, and Respiratory Syncytial Virus.Current epidemiology reports · 2026Review
- Epidemiological characteristics of pediatric respiratory pathogens and their association with climate in Wuxi, Chongqing, China.New microbes and new infections · 2025Article
- Observational
- Towards a holistic approach to pulmonary infections. Insights from the Sixth Annual Meeting of Spanish Experts 2024.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2025Review
- Podcast: Need for Quality Evidence for Decision-Making on Seasonal Influenza Vaccines.Infectious diseases and therapy · 2024Article
- Etiology of Acute Lower Respiratory Illness Hospitalizations Among Infants in 4 Countries.Open forum infectious diseases · 2023Article
- Factors Associated With the Development of Bacterial Pneumonia Related to Seasonal Influenza Virus Infection: A Study Using a Large-scale Health Insurance Claim Database.Open forum infectious diseases · 2023Article
- Influenza Virus Infection Increases Host Susceptibility To Secondary Infection with Pseudomonas aeruginosa, and This Is Attributed To Neutrophil Dysfunction through Reduced Myeloperoxidase Activity.Microbiology spectrum · 2023Article
- Review
- Capillary Blood Gas in Children Hospitalized Due to Influenza Predicts the Risk of Lower Respiratory Tract Infection.Diagnostics (Basel, Switzerland) · 2022Article
- Incidence and seasonality of respiratory viruses among medically attended children with acute respiratory infections in an Ecuador birth cohort, 2011-2014.Influenza and other respiratory viruses · 2022Article
- Etiological and epidemiological features of acute respiratory infections in China.Nature communications · 2021Article
- Pneumonia Following Symptomatic Influenza Infection Among Nicaraguan Children Before and After Introduction of the Pneumococcal Conjugate Vaccine.The Journal of infectious diseases · 2021Article
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Authors and funding
13 authors at 6 institutions in 3 countries.
Funding
Abstract
backgroundPneumonia is a leading cause of mortality worldwide. Influenza may result in primary pneumonia or be associated with secondary bacterial pneumonia. While the association with secondary pneumonia has been established ecologically, individual-level evidence remains sparse and the risk period for pneumonia following influenza poorly defined.
methodsWe conducted a matched case-control study and a prospective cohort study among Nicaraguan children aged 0-14 years from 2011 through 2018. Physicians diagnosed pneumonia cases based on Integrated Management for Childhood Illness guidelines. Cases were matched with up to 4 controls on age (months) and study week. We fit conditional logistic regression models to assess the association between influenza subtype and subsequent pneumonia development, and a Bayesian nonlinear survival model to estimate pneumonia hazard following influenza.
resultsParticipants with influenza had greater risk of developing pneumonia in the 30 days following onset compared to those without influenza (matched odds ratio [mOR], 2.7 [95% confidence interval {CI}, 1.9-3.9]). Odds of developing pneumonia were highest for participants following A(H1N1)pdm09 illness (mOR, 3.7 [95% CI, 2.0-6.9]), followed by influenza B and A(H3N2). Participants' odds of pneumonia following influenza were not constant, showing distinct peaks 0-6 days (mOR, 8.3 [95% CI, 4.8-14.5] days) and 14-20 (mOR, 2.5 [95% CI, 1.1-5.5] days) after influenza infection.
conclusionsInfluenza is a significant driver of both primary and secondary pneumonia among children. The presence of distinct periods of elevated pneumonia risk in the 30 days following influenza supports multiple etiological pathways.
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